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[Cardiac sarcoidosis - clinical manifestation and diagnosis]

Justyna Błaut-Jurkowska1, Piotr Podolec1, Maria Olszowska1

  • 1Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Cracow, Poland.

Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|September 4, 2016
PubMed

Insights

Sarcoidosis can affect the heart in 5% of patients, causing conduction issues, arrhythmias, and heart failure. Early screening with ECG and echocardiogram is crucial for timely diagnosis and management of cardiac sarcoidosis.

Area of Science:

  • Cardiology
  • Immunology
  • Internal Medicine

Background:

  • Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomas.
  • Cardiac involvement occurs in approximately 5% of sarcoidosis patients.
  • The etiology of sarcoidosis remains unknown.

Purpose of the Study:

  • To outline the diagnostic approach for cardiac sarcoidosis.
  • To emphasize the importance of screening for cardiac sarcoidosis in affected individuals.
  • To highlight the variable clinical presentation of cardiac sarcoidosis.

Main Methods:

  • Clinical history, 12-lead electrocardiogram (ECG), and echocardiogram form the initial diagnostic algorithm.
  • Advanced imaging techniques like cardiovascular magnetic resonance (CMR) and FDG-PET are used for further investigation.
  • Endomyocardial biopsy is not routinely performed.

Main Results:

  • Conduction abnormalities, arrhythmias, and heart failure are the most common manifestations of cardiac sarcoidosis.
  • Screening is recommended for all patients with extracardiac sarcoidosis.
  • Cardiac sarcoidosis can be the initial or sole manifestation in young patients with unexplained conduction abnormalities.

Conclusions:

  • Cardiac sarcoidosis requires a high index of suspicion, especially in patients with unexplained conduction defects.
  • A systematic diagnostic approach involving initial screening and advanced imaging is essential.
  • Timely diagnosis and management are critical due to the potential severity of cardiac involvement.

Keywords:
cardiac sarcoidosisclinical manifestationdiagnosisdiagnostic criteriasarcoidosissignssymptoms

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